Nurse Concierge at Oakland Rehabilitarion & Healthcare Center

• Dec 2021 - Present

Assistant Director Of Nursing

• Jul 2021 - Nov 2021

Charge Nurse

• Sep 2020 - Jul 2021

Senior Compliance Analyst

• Jan 2014 - Feb 2018

Maintain and foster an environment that enhances and promotes compliance throughout the organization. Manage New Hire and Annual Training requirements for the workforce. ***Attained a 100% completion of all active workforce members for the 2017 Annual Training within 100 days from launch, a gain of 22% from the 2016 training period. Execute Conflict of Interest (COI) requirement for all new hires. Orchestrate implementation of updates and roll out of Annual COI requirement to all employees. ***Delivered a 100% completion of all active employees for 2017 Annual Conflict of Interest requirement within 32 days of launch showing a 7% higher completion rate from 2016. Manage Annual First Tier, Downstream, Related Entity and Affiliate (FDR) Attestation drive. ***Achieved a 1.6% increase in attestations from previous year. Write/draft and maintain Compliance, Privacy and Audit articles for monthly internal Compliance Department publication. Direct the annual the Compliance Department Policy and Procedure update and review. Monitor all updates and reviews of internal compliance publications. Organize and manage annual Compliance Week activities. Show less

Operations Manager

• Oct 2012 - Jan 2014

Planned, coordinated and managed the activities of two customer and field operations teams to maintain and enhance customer relationships and meet organizational and operational objectives. • Planned, prioritized and delegated work tasks to ensure proper functioning of the department. • Directed the daily operations of the customer service and field operations teams. • Ensured the necessary resources and tools were available for quality customer service delivery. • Coordinated and implemented field representative schedules to ensure timely inspections and delivery of customer needs. • Decreased overtime hours by approximately 5%. • Developed and implemented customer service and field operation policies and procedures. • Defined and communicated customer service and field operation standards. • Reviewed customer complaints. • Tracked customer complaint resolution. • Identified and addressed staff training and coaching needs. Show less

Compliance Manager

• Jan 2007 - Apr 2011

• Worked directly with all areas of Express Script and its subsidiaries to ensure all compliance/regulatory requirements were met. • Consulted with internal customers to facilitate completion of the compliance requirements. • Reported to Compliance Management team regarding compliance deliverables. • Communicated effectively all aspects of compliance requirements to internal customers. • Engaged internal Subject Matter Expert’s (SME's) as appropriate to support training discussions and needs. • Internally escalated product needs (development, breaks, fixes) through appropriate management channels, tracking to completion. • Worked with the compliance software vendor to appropriately manage software requirements and deliverables. • Developed proactive risk and control as related to compliance. • Generated Standard Operation Procedures (SOP’s) in conjunction with compliance modules. Show less

Lead Compliance Auditor

• Dec 2003 - Jan 2007

This position was responsible for the execution of Compliance audits to assess Horizon's level of compliance with regulatory mandates and internal operating procedures. The position was accountable for overseeing work of other auditors as well as performing complex auditing functions. Key responsibilities included, but were not limited to the following: 1) Lead and performed Mandate audits, as assigned, to determine compliance with Federal and State mandated benefits, including payment of claims in accordance with mandated benefit provisions, proper communication of mandated benefits in participant and group correspondence and contracts, review of internal operating procedures and review system changes implemented for the mandate. 2) Identified potential risks, audit scope and staffing requirements. 3) Prepared and reviewed formal written reports of audit findings and conclusions. 4) Served as a subject matter expert across enterprise in order to communicate identified trends and recommend corrective action for claim payment errors resulting from the improper implementation of mandates. 5) Assisted the audit manager in the development of audit procedures. 6) Trained and developed auditors. 7) Participated in the mandate risk assessment process and with the development of the annual mandate audit plan. Show less

Senior Proposal Editor

• Jul 2002 - Dec 2003

Team Service Representative

• Aug 1996 - Sep 1998

Account Receivable Clerk

• Apr 1996 - Aug 1996